Below is general information about Insurance Advocates for residential programs including therapeutic boarding schools, residential treatment centers, and wilderness therapy programs.
It is worthwhile to have a professional review your policy to understand what reimbursement you may anticipate. Contact information for three Insurance Advocates is included below.
Is Wilderness Therapy covered by insurance?
As a general rule, wilderness therapy is excluded in most policies. This does not mean that you are not potentially eligible for some degree of reimbursement. While not a guarantee, families are increasingly being reimbursed a percentage of program costs, though 100% is extremely rare.
Are Therapeutic Boarding Schools or Residential Treatment Centers covered by insurance?
The nuances of the insurance industry are vast. Portions of TBS/RTC treatment can be billed directly or reimbursed. Many programs require private pay options up front with support of Super Bill for reimbursement afterwards. Most TBS/RTC’s are not in-network. Please be sure to understand how each program works with insurance and Insurance Advocates.
Do you recommend that families navigate insurance reimbursement on their own?
Families that attempt to process claims on their own for wilderness are denied coverage over 90% of the time. TBS/RTC’s have a wide range of insurance participation. I strongly recommend families work with an Insurance Advocate that offers experienced professionals and services to navigate the nuances of your specific insurance plan and the claims process.
What services do Insurance Advocates offer?
Insurance Advocates manage health insurance claims to help you develop and implement a strategy to achieve maximum coverage. They will provide a free initial consultation, perform a verification of benefits, support any preauthorization requirements, and address all correspondence with your insurance company including coding, claim creation, electronic claim submission, corrections, appeals and denials.
When should I connect with an Insurance Advocate?
We recommend contacting an Insurance Advocate prior to enrollment. This ensures that your policy will be professionally reviewed with a verification of benefits completed so can know what to expect from your insurance plan and understand your reimbursement strategy. If you are unable to contact an Insurance Advocate before enrollment, we advise you contact one as soon as possible.
Are all Insurance Advocates the same?
No, each Insurance Advocate offers differing strategies, services, and fee structures. Fee structures include hourly, flat fees, and percentage of reimbursement. It is up to the family to determine which Insurance Advocate best aligns with your goals.